Facility Evaluation Report

At approximately 1:35PM Licensing Program Analysts (LPAs) Helena Rummonds and Jacky Macias arrived unannounced to conduct a case management inspection on an Incident Report that occurred on 2/22/2024 and was received by CCL on 02/27/2024. LPAs met with Executive Director (ED), Jessica Graham, and discussed the purpose of the visit.

Incident Report states that Resident 1 (R1) drank Resident 2 (R2s) liquid medication (citalopram 10mls). R1 did not have an order for the medication that was consumed. Medication Technician on duty informed R1s primary care provider and R1s spouse. PCP stated that there would be no adverse affects.

Per conversation with Executive Director, the medication technician placed the medication on the counter and turned around leaving the medication accessible to other residents when R1 drank the medication.

**An immediate civil penalty in the total amount of $250.00 has been issued for a repeat violation of regulation 87465(a)(4). LIC421FC**

Exit interview conducted. Copy of report, LIC-809D, LIC421FC (Civil Penalty Assessment), LIC811 (Confidential Names), Plan of Corrections, and Appeal Rights discussed and provided to Executive Director. Signature on form confirms receipt of documents.